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How to treat neck and shoulder pain?

source:Zhejiang Banger Medical Investment Management Co., Ltd.     Date of publication:2019-06-12     Browsing volume:1208

Guide reading:

As our society gradually enters an aging society and diversified lifestyles, patients with neck, shoulder, back and leg pain show an increasing trend, especially in the elderly. After the weather changes and sports, they feel neck and shoulders, waist and leg pain, numbness, Swelling seriously affects work and daily life.

Usually, low back pain includes six categories: congenital malformations, damaging diseases, spinal tumors, inflammatory diseases, metabolic diseases, and degenerative diseases. There are several common types of neck and shoulder pain, such as inflammation, tumor, and degenerative diseases (cervical spondylosis).

The clinical manifestations of neck, shoulder, back and leg pain are not the same, and there are many treatment methods. Some patients can get better results through conservative treatment, rehabilitation treatment, rest, and some must be treated with surgery.

First, congenital malformations

The most common are lumbosacral sulcus and transitional vertebrae. There are two ossification centers in the lumbosacral region. If the human body is not completely ossified before it stops developing, it will form a “fissure” in the lumbar vertebrae or the atlas. This is the “recessive spina bifida” often mentioned in our clinical photo report. ", is congenital. The transitional vertebrae are characterized by lumbosacral variation, axillary lumbar vertebrae (an additional lumbar vertebra), and lumbar vertebrae degeneration (with one less lumbar vertebra), such as how long or less a vertebral body grows. It sounds like a very serious condition, but in fact there is a relatively high incidence in the population. Similar to the size of the foot is not a disease, is a variation in human growth.

Many cracks do not cause symptoms, and most patients do not need surgery. However, the local structure of the cryptic fissure is weak, and it is easy to cause chronic low back pain due to strain. Some patients have some different places in the spine. Some traumatic injuries and symptoms are easy to occur. At this time, targeted surgery is needed.

"clear crack" patient protection measures

Usually do not sit for a long time standing, long bending weight, strenuous exercise or waist trauma, while paying attention to local warmth.

Another type of congenital malformation is dense osteitis, which is actually a manifestation of degeneration, a manifestation of age, and generally does not require surgery.

Second, the injury disease

Including acute lumbar sprain, supraspinous ligament injury, lumbar facet joint syndrome, fibrositis and other types, of which acute lumbar sprain is the most common.

Acute lumbar sprains often occur when suddenly moving heavy objects, holding children, doing housework, etc., accidentally twisting to the waist and sudden pain, fixed in a position, a painful pain, or accompanied by leg pain. Many people are more scared when they encounter this situation. In fact, it is only an acute muscle or ligament strain, combined with lumbar facet joint contusion.

In this case, you should immediately brake, then rest in bed, there will be some relief after a period of time, with rehabilitation therapy, one to two weeks will basically recover. Although the problem is not big, the rehabilitation process also needs time conditioning. It is not effective to take medicine immediately. During the period, you should avoid running around and rest in bed as much as possible.

Spinal ligament injury, lumbar facet joint syndrome, and fibrositis (chronic) are pain caused by lumbar muscle strain and chronic injury, often caused by long-term housework, heavy loads, bending weight, strenuous exercise, and excessive waist load. Such as the cause, such patients should strictly follow the doctor's advice to strengthen rest, rehabilitation or medical treatment, and appropriate exercise.

Third, spinal tumor

Spinal tumors are commonly known as cancerous, with primary benign, primary malignant and metastatic.

The incidence of carcinoma in situ in the spine is very small, and most tumors are metastasized, including cancer cells such as prostate cancer, lung cancer, and breast cancer.

Primary benign tumors can be asymptomatic or have no obvious symptoms, have little effect on life, generally do not require surgery, and only need to be treated with caution when symptoms are obvious or other diseases are caused.

The primary malignant tumor and metastatic tumor (both malignant) will be treated as soon as possible. Primary malignant spinal tumors often show a persistent increase in low back pain, which can not be relieved in bed. It can be painful whether lying down, sleeping or walking, especially at night. Metastatic spinal tumors often occur in middle-aged and elderly patients, and other organ inflammation or chronic diseases, such as prostatitis, ovarian inflammation, mastitis, etc., should be regularly checked and screened.

Most patients with primary malignant tumors and metastases need surgery, and early detection and early treatment should be performed after half a year to one year. If there is a history of other tumors, even if the primary tumor has been removed or the condition is well controlled, A bone scan must also be performed from six months to one year.

Fourth, inflammatory diseases (bacteria, viral infection)

1, lumbar tuberculosis

In recent years, the number of lumbar tuberculosis and bone tuberculosis has increased. Spinal tuberculosis is a chronic, low-toxic bacteria characterized by difficulty in killing, swaying around, and as the blood reaches the lumbar vertebrae, grows and reproduces in the bones, producing a pustule compression nerve, which produces significant back pain. Low fever and other symptoms.

2, suppurative spondylitis

In addition to back pain, accompanied by physical discomfort or physical weakness, afternoon hot flashes, sweating, high fever and other systemic symptoms are heavier. Attention should be paid to the identification of lumbar tuberculosis when diagnosed.

Fifth, metabolic diseases

As the population ages, the incidence of osteoporosis increases year by year, and osteoporosis affects the spine, limbs, and joints, and the accompanying diseases increase. After osteoporosis occurs, the ability of the bone to resist striking is greatly diminished. In severe cases, the kettle can also fracture. Especially in women, after menopause, estrogen declines, ovarian function declines, bone splitting ability rises sharply, and "postmenopausal osteoporosis" occurs.

Patients with osteoporosis should pay special attention to prevent falls, adhere to standardized medication, exercise properly, and sun. Patients with osteoporotic fractures and surgical indications require surgery.

1, vertebral compression fracture

Often occurring in elderly patients with osteoporosis, it can also occur in young people with long-term use of glucocorticoids. Clinical manifestations are pain and deformity. If conservative treatment is not effective, or patients who are not allowed to stay in bed for a long time, such as age and general condition, you can choose minimally invasive surgery.

Treatment: percutaneous kyphoplasty (PKP), percutaneous injection of bone cement (PVP).

2, vertebral compression fracture with kyphosis (humpback)

If the compression fracture is not treated properly, 90% of the fractures will have kyphosis, the height will be short, and the hunchback deformity (occurs in the most active part). As the deformity progresses, it will seriously affect the function of the spine, such as not standing upright, activity. Pain and so on.

Treatment: osteotomy orthopedics.

Six, degenerative diseases

Degenerative diseases mainly include lumbar disc herniation, lumbar spinal stenosis, lumbar spondylolisthesis, and degenerative lumbar spondylolisthesis.

1, lumbar disc herniation

Lumbar disc herniation is very common, typical of low back pain, sciatica (radioactive leg pain), lateral calf to heel or foot and back, straight leg elevation and strengthening positive.

Lumbar disc herniation treatment requires specific analysis:

In general, most lumbar disc herniation does not require surgery or rehabilitation. Bed rest and taking anti-inflammatory painkillers will slowly improve. As time goes by and age increases, the highlights are automatically lifted.

However, for the fibrous ring has been broken, free, combined with adhesion, instability, spinal stenosis, unbearable pain, or existing muscle weakness, bowel movements and sexual dysfunction, too painful, too large and other surgical indications, can Surgical treatment.

2, lumbar spinal stenosis

Typical manifestations are low back pain, leg pain, intermittent claudication, severe symptoms, mild signs, negative straight leg test, patients with unbearable pain or unbearable conservative methods, most require surgery.

3, lumbar spondylolisthesis (vertebral body dislocation)

As you age, the bone function is not as good as before, and slippage occurs. It is divided into two types: spondylolisthesis (true spondylolisthesis) and degenerative lumbar spondylolisthesis (false spondylolisthesis). If the symptoms of pain are severe, conservative treatment is ineffective and progresses, requiring surgery.

4, degenerative lumbar spondylolisthesis

Degenerative lumbar spondylolisthesis has a female incidence rate of 6 times higher than that of males, and is common in elderly patients. Spondylolisthesis is no more than 33% (I-II degree). Intermittent claudication and sciatica occur when the disease occurs. In severe cases, nerve damage is caused. Most patients require surgery.

Seven, neck and shoulder pain

Causes of neck and shoulder pain are inflammation, tumor, degenerative diseases - cervical spondylosis. Cervical spondylosis is divided into cervical type, vertebral artery type, nerve root type and spinal cord type. Symptoms include dizziness, neck and shoulder pain, numbness of arms and limbs, weakness of limbs, walking feeling of cotton, and slow movement of hands. Pathologically positive, sputum reflexes, sputum, etc.

Cervical spondylosis of the spinal cord type and part of the nerve root type needs to be treated with decompression by surgery.

Most of the remaining types of cervical spondylosis can be improved by non-surgical treatment:

Rest, traction therapy

medical treatement

Physiotherapy

Massage

Acupuncture therapy

Needle knife therapy

Closed therapy


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